“…13 Punctate palmoplantar keratoderma is an is an autosomal dominant genodermatosis that affects both palms and soles; histology shows marked hyperkeratosis, parakeratosis, and mild acanthosis without significant dermal changes. 14 Usually no treatment is required for AKE because lesions are benign and mostly asymptomatic, however topical 10% salicylic acid 15 , urea, calcipotriol and corticosteroids, systemic or topical retinoids, Nd-YAG and Er:YAG lasers 16 , cryosurgery and iontophoresis 1,7,17 have been tried with transient and minor benefits. In the case described, we first tried 8% salicylic acid, with no significant improvement, so we opted for an emollient cream with 5% urea.…”